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Alerting, orienting and executive control: the effects of sleep deprivation on attentional networks
Martella D, Casagrande M, Lupiáñez J.
Dipartimento di Psicologia, Sapienza Università di Roma, Via dei Marsi No. 78, 00185 Rome, Italy.
Exp Brain Res. 2011 Apr;210(1):81-9. Epub 2011 Mar 10.
Abstract
Sleep deprivation alters attentional functions like vigilance or tonic alerting (i.e., sustaining an alert state over a period of time). However, the effects of sleep loss on both orienting and executive control are still not clear, and no study has assessed whether sleep deprivation might affect the relationships among these three attentional systems. In order to investigate the efficiency of the three attentional networks--alerting, orienting and executive control--within a single task, we used the Attention Network Test (ANT). Eighteen right-handed male participants took part in the experiment, which took place on two consecutive days. On the first day, each participant performed a 20 min training session of the ANT. On the second day, participants remained awake for 24 h during which time the ANT was performed once at 5:00 p.m. and once at 4:00 a.m. Results showed an overall slowing of reaction times in the nocturnal session, indicating a strong decrease in vigilance. Furthermore, sleep deprivation did affect attentional orienting and executive control. Results are consistent with the hypothesis that the tonic component of alerting interacts with both attentional orienting and executive functions.
Martella D, Casagrande M, Lupiáñez J.
Dipartimento di Psicologia, Sapienza Università di Roma, Via dei Marsi No. 78, 00185 Rome, Italy.
Exp Brain Res. 2011 Apr;210(1):81-9. Epub 2011 Mar 10.
Abstract
Sleep deprivation alters attentional functions like vigilance or tonic alerting (i.e., sustaining an alert state over a period of time). However, the effects of sleep loss on both orienting and executive control are still not clear, and no study has assessed whether sleep deprivation might affect the relationships among these three attentional systems. In order to investigate the efficiency of the three attentional networks--alerting, orienting and executive control--within a single task, we used the Attention Network Test (ANT). Eighteen right-handed male participants took part in the experiment, which took place on two consecutive days. -
Sleep, sleepiness, fatigue, and performance of 12-hour-shift nurses
Geiger-Brown J, Rogers VE, Trinkoff AM, Kane RL, Bausell RB, Scharf SM.
Work and Health Research Center , University of Maryland School of Nursing , Baltimore, Maryland , USA.
Chronobiol Int. 2012 Mar;29(2):211-9.
Abstract
Nurses working 12-h shifts complain of fatigue and insufficient/poor-quality sleep. Objectively measured sleep times have not been often reported. This study describes sleep, sleepiness, fatigue, and neurobehavioral performance over three consecutive 12-h (day and night) shifts for hospital registered nurses. Sleep (actigraphy), sleepiness (Karolinska Sleepiness Scale [KSS]), and vigilance (Performance Vigilance Task [PVT]), were measured serially in 80 registered nurses (RNs). Occupational fatigue (Occupational Fatigue Exhaustion Recovery Scale [OFER]) was assessed at baseline. Sleep was short (mean 5.5 h) between shifts, with little difference between day shift (5.7 h) and night shift (5.4 h). Sleepiness scores were low overall (3 on a 1-9 scale, with higher score indicating greater sleepiness), with 45% of nurses having high level of sleepiness (score > 7) on at least one shift. Nurses were progressively sleepier each shift, and night nurses were sleepier toward the end of the shift compared to the beginning. There was extensive caffeine use, presumably to preserve or improve alertness. Fatigue was high in one-third of nurses, with intershift fatigue (not feeling recovered from previous shift at the start of the next shift) being most prominent. There were no statistically significant differences in mean reaction time between day/night shift, consecutive work shift, and time into shift. Lapsing was traitlike, with rare (39% of sample), moderate (53%), and frequent (8%) lapsers. Nurses accrue a considerable sleep debt while working successive 12-h shifts with accompanying fatigue and sleepiness. Certain nurses appear more vulnerable to sleep loss than others, as measured by attention lapses.
Geiger-Brown J, Rogers VE, Trinkoff AM, Kane RL, Bausell RB, Scharf SM.
Work and Health Research Center , University of Maryland School of Nursing , Baltimore, Maryland , USA.
Chronobiol Int. 2012 Mar;29(2):211-9.
Abstract
Nurses working 12-h shifts complain of fatigue and insufficient/poor-quality sleep. Objectively measured sleep times have not been often reported. This study describes sleep, sleepiness, fatigue, and neurobehavioral performance over three consecutive 12-h (day and night) shifts for hospital registered nurses. Sleep (actigraphy), sleepiness (Karolinska Sleepiness Scale [KSS]), and vigilance (Performance Vigilance Task [PVT]), were measured serially in 80 registered nurses (RNs). Occupational fatigue (Occupational Fatigue Exhaustion Recovery Scale [OFER]) was assessed at baseline. Sleep was short (mean 5.5 h) between shifts, with little difference between day shift (5.7 h) and night shift (5.4 h). -
Effects of partial circadian adjustments on sleep and vigilance quality during simulated night work
Chapdelaine S, Paquet J, Dumont M.
Chronobiology Laboratory, Center for Advanced Research in Sleep Medicine, Sacre-Coeur Hospital of Montreal, Montreal, QC, Canada Department of Psychiatry, University of Montreal, Montreal, QC, Canada.
J Sleep Res. 2012 Feb 14. doi: 10.1111/j.1365-2869.2012.00998.x. [Epub ahead of print]
Abstract
In most situations, complete circadian adjustment is not recommended for night workers. With complete adjustment, workers experience circadian misalignment when returning on a day-active schedule, causing repeated circadian phase shifts and internal desynchrony. For this reason, partial circadian realignment was proposed as a good compromise to stabilize internal circadian rhythms in night shift workers. However, the extent of partial circadian adjustment necessary to improve sleep and vigilance quality is still a matter of debate. In this study, the effects of small but statistically significant partial circadian adjustments on sleep and vigilance quality were assessed in a laboratory simulation of night work to determine whether they were also of clinical significance. Partial adjustments obtained by phase delay or by phase advance were quantified not only by the phase shift of dim light salivary melatonin onset, but also by the overlap of the episode of melatonin production with the sleep-wake cycle adopted during simulated night work. The effects on daytime sleep and night-time vigilance quality were modest. However, they suggest that even small adjustments by phase delay may decrease the accumulation of sleep debt, whereas the advance strategy improves subjective alertness and mood during night work. Furthermore, absolute phase shifts, by advance or by delay, were associated with improved subjective alertness and mood during the night shift. These strategies need to be tested in the field, to determine whether they can be adapted to real-life situations and provide effective support to night workers.
Chapdelaine S, Paquet J, Dumont M.
Chronobiology Laboratory, Center for Advanced Research in Sleep Medicine, Sacre-Coeur Hospital of Montreal, Montreal, QC, Canada Department of Psychiatry, University of Montreal, Montreal, QC, Canada.
J Sleep Res. 2012 Feb 14. doi: 10.1111/j.1365-2869.2012.00998.x. [Epub ahead of print]
Abstract
In most situations, complete circadian adjustment is not recommended for night workers. With complete adjustment, workers experience circadian misalignment when returning on a day-active schedule, causing repeated circadian phase shifts and internal desynchrony. For this reason, partial circadian realignment was proposed as a good compromise to stabilize internal circadian rhythms in night shift workers. However, the extent of partial circadian adjustment necessary to improve sleep and vigilance quality is still a matter of debate. -
Sleep problems are associated with binge eating in women
Trace SE, Thornton LM, Runfola CD, Lichtenstein P, Pedersen NL, Bulik CM.
Department of Psychiatry, University of North Carolina, Chapel Hill, North Carolina.
Int J Eat Disord. 2012 Feb 13. doi: 10.1002/eat.22003. [Epub ahead of print]
OBJECTIVE:
We examined the association among current self-reported sleep problems, lifetime binge eating (BE), and current obesity in women from the Swedish Twin study of Adults: Genes and Environment.METHOD:
Logistic regression analyses were used to evaluate these associations in 3,790 women aged 20-47 years.RESULTS:
BE was reported by 244 (6.4%) women and was positively associated with not getting enough sleep (p < .015), sleeping poorly (p < .001), problems falling asleep (p < .001), feeling sleepy during work or free time (p < .001), and disturbed sleep (p < .001). These same sleep variables, as well as napping and being a night person, were also significantly associated with obesity. The associations between BE and sleep remained after accounting for obesity.DISCUSSION:
This investigation offers empirical support for an independent association between sleep problems and BE, which is likely due to complex psychological, biological, neuroendocrine, and metabolic factors. © 2012 by Wiley Periodicals, Inc.
Trace SE, Thornton LM, Runfola CD, Lichtenstein P, Pedersen NL, Bulik CM.
Department of Psychiatry, University of North Carolina, Chapel Hill, North Carolina.
Int J Eat Disord. 2012 Feb 13. doi: 10.1002/eat.22003. [Epub ahead of print]
OBJECTIVE:
We examined the association among current self-reported sleep problems, lifetime binge eating (BE), and current obesity in women from the Swedish Twin study of Adults: Genes and Environment.METHOD:
Logistic regression analyses were used to evaluate these associations in 3,790 women aged 20-47 years.RESULTS:
BE was reported by 244 (6.4%) women and was positively associated with not getting enough sleep (p < .015), sleeping poorly (p < .001), problems falling asleep (p < .001), feeling sleepy during work or free time (p < .001), and disturbed sleep (p < .001). -
Sleep in Older Chronic Pain Patients: A Comparative Polysomnographic Study
Blågestad T, Pallesen S, Lunde LH, Sivertsen B, Nordhus IH, Grønli J.
Departments of *Clinical Psychology †Psychosocial Science ∥Biological and Medical Psychology, University of Bergen §Norwegian Institute of Public Health, Division of Mental Health ‡Norwegian Competence Center for Sleep Disorders, Haukeland University Hospital, Bergen, Norway.
Clin J Pain. 2012 Feb 10. [Epub ahead of print]
OBJECTIVES:
The relationship between chronic pain and sleep disturbances is not yet fully understood, despite much evidence linking them. Polysomnography is the gold standard for assessing sleep architecture, and in this naturalistic study, we wanted to compare both macrostructure and microstructure sleep variables in older chronic pain patients with healthy older persons using polysomnography.METHODS:
Sleep variables investigated in this study include sleep onset latency, total sleep time, wake time after sleep onset, sleep efficiency, sleep latencies to different sleep stages, number of awakenings, time spent in each sleep stage, and arousal index, as well as apnea-hypopnea index and periodic leg movement index. In addition, the power spectrum of the α and δ frequency bands was analyzed.RESULTS:
The chronic pain group spent significantly longer time in bed and had poorer sleep than the control group in terms of sleep onset latency, sleep latency to N2, sleep efficiency, wake time after sleep onset, and number of awakenings. However, sleep duration and time spent in each sleep stage did not differ between the 2 groups. The composition of power spectrum frequencies revealed that older people with chronic pain have lower intensity in the δ frequencies (0.5 to 1.99 Hz and 2 to 4 Hz) throughout the whole night, especially in the first 6 hours. The findings are in accordance with the idea that the quality of sleep while in chronic pain is particularly characterized by difficulties with the wake-sleep transition and a lower intensity of the deep restorative sleep throughout the night.
Blågestad T, Pallesen S, Lunde LH, Sivertsen B, Nordhus IH, Grønli J.
Departments of *Clinical Psychology †Psychosocial Science ∥Biological and Medical Psychology, University of Bergen §Norwegian Institute of Public Health, Division of Mental Health ‡Norwegian Competence Center for Sleep Disorders, Haukeland University Hospital, Bergen, Norway.
Clin J Pain. 2012 Feb 10. [Epub ahead of print]
OBJECTIVES:
The relationship between chronic pain and sleep disturbances is not yet fully understood, despite much evidence linking them. Polysomnography is the gold standard for assessing sleep architecture, and in this naturalistic study, we wanted to compare both macrostructure and microstructure sleep variables in older chronic pain patients with healthy older persons using polysomnography. -
Does lack of sleep cause diabetes?
Touma C, Pannain S.
Department of Medicine, Section of Endocrinology, The University of Chicago, IL
Cleve Clin J Med. 2011 Aug;78(8):549-58. doi: 10.3949/ccjm.78a.10165.
Abstract
Several lines of evidence indicate that chronic lack of sleep may contribute to the risk of type 2 diabetes mellitus. Adequate sleep and good sleep hygiene should be included among the goals of a healthy lifestyle, especially for patients with diabetes. We urge clinicians to recommend at least 7 hours of uninterrupted sleep per night as part of a healthy lifestyle.
Touma C, Pannain S.
Department of Medicine, Section of Endocrinology, The University of Chicago, IL
Cleve Clin J Med. 2011 Aug;78(8):549-58. doi: 10.3949/ccjm.78a.10165.
Abstract
Several lines of evidence indicate that chronic lack of sleep may contribute to the risk of type 2 diabetes mellitus. Adequate sleep and good sleep hygiene should be included among the goals of a healthy lifestyle, especially for patients with diabetes. We urge clinicians to recommend at least 7 hours of uninterrupted sleep per night as part of a healthy lifestyle. -
Insomnia symptoms influence CPAP compliance
Pieh C, Bach M, Popp R, Jara C, Crönlein T, Hajak G, Geisler P.
Department of Psychiatry and Psychotherapy, Sleep Disorder Center, University Medical Center Regensburg, Regensburg, Germany
Sleep Breath. 2012 Feb 4. [Epub ahead of print]
PURPOSE:
The aim of this study is to determine parameters which influence 6-month compliance of continuous positive airway pressure therapy (CPAP) in patients with obstructive sleep apnea syndrome (OSAS).METHODS:
This prospective study investigated 73 patients (24 females) with OSAS and medical indication for CPAP therapy: age 55.1 ± 11.5 years, body mass index (BMI) 30.8 ± 5.0 kg/m2, Apnea-Hypopnea Index (AHI) 39.2 ± 26.7/h, Oxygen Desaturation Index (ODI) 33.2 ± 25.4/h, minimum O(2) saturation 78.9 ± 7.6%. The influence of baseline parameters (demographic and polysomnographic data, sleeping medication intakes, BMI, psychometrics [Epworth Sleepiness Scale, Regensburg Insomnia Scale, Vigilance test and Beck Depression Inventory]) on 6-month compliance was evaluated with a correlation and a linear regression analysis.RESULTS:
The baseline value of the Regensburg Insomnia Scale (RIS) predicts 6-month CPAP compliance (r = -0.376, R (2) = 0.14, p < 0.001), although no other baseline parameter correlates. Patients with a compliance of <4 h/night show higher RIS scores, i.e., more insomnia symptoms (17.6 ± 8.8) compared to those with ≥4 h/night (12.6 ± 6.9; p < 0.05).CONCLUSIONS:
Insomnia symptoms prior to the beginning of CPAP treatment show a negative influence on CPAP compliance. Further studies should clarify, if a treatment of insomnia symptoms leads to a benefit in compliance.
Pieh C, Bach M, Popp R, Jara C, Crönlein T, Hajak G, Geisler P.
Department of Psychiatry and Psychotherapy, Sleep Disorder Center, University Medical Center Regensburg, Regensburg, Germany
Sleep Breath. 2012 Feb 4. [Epub ahead of print]
PURPOSE:
The aim of this study is to determine parameters which influence 6-month compliance of continuous positive airway pressure therapy (CPAP) in patients with obstructive sleep apnea syndrome (OSAS).METHODS:
This prospective study investigated 73 patients (24 females) with OSAS and medical indication for CPAP therapy: age 55.1 ± 11.5 years, body mass index (BMI) 30.8 ± 5.0 kg/m2, Apnea-Hypopnea Index (AHI) 39.2 ± 26.7/h, Oxygen Desaturation Index (ODI) 33.2 ± 25.4/h, minimum O(2) saturation 78.9 ± 7.6%. -
Sleep disorders and demand for medical services: evidence from a population-based longitudinal study
Santos-Silva R, Castro LS, Taddei JA, Tufik S, Bittencourt LR.
Disciplina de Medicina e Biologia do Sono, Departamento de Psicobiologia, Universidade Federal de São Paulo - UNIFESP, São Paulo, Brazil.
PLoS One. 2012;7(2):e30085. Epub 2012 Feb 1.
BACKGROUND:
The aim of this study was to investigate whether insomnia and obstructive sleep apnea (OSA) were predictors of hospitalizations or emergency department visits during two years following the Sao Paulo Epidemiologic Sleep Study (EPISONO) sample.METHODS AND FINDINGS:
All participants (n = 1,101) who underwent a baseline evaluation between July and December 2007 were contacted in December 2009 and asked to fill out a questionnaire about body weight changes, number of hospitalizations and visits to the emergency department. Participants lost during the follow-up period represented 3.2% (n = 35) and 7 subjects had died. Hospitalizations were reported by 116 volunteers (10.5%) and emergency department visits were reported by 136 participants (12.4%). The average body mass index (BMI) did not vary significantly between the first and the second assessment [26.7(95%CI:26.3-27.1) vs. 26.9(26.5-27.4) kg/m2]. After adjusting for confounders, a multiple logistic regression model revealed that female gender [1.4(1.0-1.9)], age ≥40 years, insomnia diagnosed according to the DSM-IV criteria [1.6(1.0-2.6)], and apnea-hypopnea index ≥15 [1.5(1.0-2.2)] were predictors of hospitalizations and/or demand for emergency services.CONCLUSION:
Our study of a probabilistic sample of the Sao Paulo inhabitants shows that over a period of two years, insomnia and OSA were both associated with health impairment. Considering the high prevalence and public health burden of sleep disorders, the consequences of untreated disease for both the individual and society are undeniable and should be addressed.
Santos-Silva R, Castro LS, Taddei JA, Tufik S, Bittencourt LR.
Disciplina de Medicina e Biologia do Sono, Departamento de Psicobiologia, Universidade Federal de São Paulo - UNIFESP, São Paulo, Brazil.
PLoS One. 2012;7(2):e30085. Epub 2012 Feb 1.
BACKGROUND:
The aim of this study was to investigate whether insomnia and obstructive sleep apnea (OSA) were predictors of hospitalizations or emergency department visits during two years following the Sao Paulo Epidemiologic Sleep Study (EPISONO) sample.METHODS AND FINDINGS:
All participants (n = 1,101) who underwent a baseline evaluation between July and December 2007 were contacted in December 2009 and asked to fill out a questionnaire about body weight changes, number of hospitalizations and visits to the emergency department. Participants lost during the follow-up period represented 3.2% (n = 35) and 7 subjects had died. -
Night Shift Work and Hormone Levels in Women
Davis S, Mirick DK, Chen C, Stanczyk FZ.
Cancer Epidemiol Biomarkers Prev. 2012 Feb 7. [Epub ahead of print]
Epidemiology, Fred Hutchinson Research Center.
BACKGROUND:
Nightshift work may disrupt the normal nocturnal rise in melatonin, resulting in increased breast cancer risk, possibly through increased reproductive hormone levels. We investigated whether nightshift work is associated with decreased levels of urinary 6-sulfatoxymelatonin, the primary metabolite of melatonin, and increased urinary reproductive hormone levels.METHODS:
Participants were 172 nightshift and 151 dayshift-working nurses, aged 20-49, with regular menstrual cycles. Urine samples were collected throughout work and sleep periods and assayed for 6-sulfatoxymelatonin, LH, FSH, and E1C.RESULTS:
6-sulfatoxymelatonin levels were 62% lower and FSH and LH were 62% and 58% higher, respectively, in nightshift-working women during daytime sleep compared to dayshift-working women during nighttime sleep (p≤0.0001). Nighttime sleep on off nights was associated with 42% lower 6-sulfatoxymelatonin levels among the nightshift workers, relative to the dayshift workers (p<0.0001); no significant differences in LH or FSH were observed. 6-sulfatoxymelatonin levels during night work were approximately 69% lower and FSH and LH were 35% and 38% higher, compared to dayshift workers during nighttime sleep. No differences in E1C levels between night and day shift workers were observed. Within nightshift workers, 6-sulfatoxymelatonin levels were lower and reproductive hormone levels were higher during daytime sleep and nighttime work, relative to nighttime sleep (p<0.05).CONCLUSIONS:
These results indicate nightshift workers have substantially reduced 6-sulfatoxymelatonin levels during night work and daytime sleep, and that levels remain low even when a nightshift worker sleeps at night.Impact:Shift work could be an important risk factor for many other cancers in addition to breast cancer.
Davis S, Mirick DK, Chen C, Stanczyk FZ.
Cancer Epidemiol Biomarkers Prev. 2012 Feb 7. [Epub ahead of print]
Epidemiology, Fred Hutchinson Research Center.
BACKGROUND:
Nightshift work may disrupt the normal nocturnal rise in melatonin, resulting in increased breast cancer risk, possibly through increased reproductive hormone levels. We investigated whether nightshift work is associated with decreased levels of urinary 6-sulfatoxymelatonin, the primary metabolite of melatonin, and increased urinary reproductive hormone levels.METHODS:
Participants were 172 nightshift and 151 dayshift-working nurses, aged 20-49, with regular menstrual cycles. Urine samples were collected throughout work and sleep periods and assayed for 6-sulfatoxymelatonin, LH, FSH, and E1C. -
Sleep-related problems in neurologic diseases
Dyken ME, Afifi AK, Lin-Dyken DC.
Sleep Disorders Center, University of Iowa Hospitals and Clinics, 200 Hawkins Dr, Iowa City, IA
Chest. 2012 Feb;141(2):528-44.
Abstract
There is a strong association between sleep-related problems and neurologic diseases. Neurologic diseases of the CNS can directly cause sleep problems when sleep-wake mechanisms associated with the ascending reticular activating system are involved. The major sleep disorders associated with neurologic problems are outlined in the International Classification of Sleep Disorders, 2nd edition, as hypersomnias of central origin, sleep-related breathing disorders, the insomnias, circadian rhythm sleep disorders, sleep-related movement disorders, parasomnias, and sleep-related epilepsy. In a patient with CNS disease and excessive sleepiness, sleep-related breathing disorders should be a first concern, given the known association between obstructive sleep apnea (OSA) and cerebrovascular disease and the potential confounding effects that OSA might have on an otherwise compromised ischemic CNS penumbra. A basic knowledge of the anatomy and physiology of the sleep-wake mechanisms provides a rationale for pharmacologic intervention. Nonpharmacologic treatments are also important, especially when sleep-related breathing disorders are a concern. In addition, as patients with neurologic diseases are often prone to the adverse effects of many medications, the specific treatment regimen for any given individual should always include good sleep hygiene practices that use cognitive behavioral therapy.
Dyken ME, Afifi AK, Lin-Dyken DC.
Sleep Disorders Center, University of Iowa Hospitals and Clinics, 200 Hawkins Dr, Iowa City, IA
Chest. 2012 Feb;141(2):528-44.
Abstract
There is a strong association between sleep-related problems and neurologic diseases. Neurologic diseases of the CNS can directly cause sleep problems when sleep-wake mechanisms associated with the ascending reticular activating system are involved. The major sleep disorders associated with neurologic problems are outlined in the International Classification of Sleep Disorders, 2nd edition, as hypersomnias of central origin, sleep-related breathing disorders, the insomnias, circadian rhythm sleep disorders, sleep-related movement disorders, parasomnias, and sleep-related epilepsy.
